Provider Demographics
NPI:1922444116
Name:WHITE, DANA (RN, MSN)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2043 N HOLGUIN WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-2965
Mailing Address - Country:US
Mailing Address - Phone:480-235-3542
Mailing Address - Fax:
Practice Address - Street 1:2043 N HOLGUIN WAY
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-2965
Practice Address - Country:US
Practice Address - Phone:480-235-3542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-15
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ138689163WS0200X
AZRN138689163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WS0200XNursing Service ProvidersRegistered NurseSchool